Insertion of the intraepiphyseal K-wire

A smooth 1.25-1.6 mm K-wire is inserted through the radial epiphysis in a direction determined by the fracture pattern. The K-wire should ideally cross the fracture plane as near to 90° as the fracture anatomy permits.

The wire should be inserted with an oscillating drill and cooled with saline solution to prevent thermal injury.

Alternative: Cannulated screw

In the child nearing skeletal maturity an intra epiphyseal lag screw can be inserted. Using the intraepiphyseal wire as a guide, a cannulated screw is inserted over the wire with the appropriate soft-tissue protection, provided the full instrumentation is available.